Impact of psychological stress on irritable bowel syndrome

Psychological stress is an important factor for the development of irritable bowel syndrome(IBS). More and more clinical and experimental evidence showed that IBS is a combination of irritable bowel and irritable brain. In the present review we discuss the potential role of psychological stress in the pathogenesis of IBS and provide comprehensive approaches in clinical treatment. Evidence from clinical and experimental studies showed that psychological stresses have marked impact on intestinal sensitivity, motility, secretion and permeability, and the underlying mechanism has a close correlation with mucosal immune activation, alterations in central nervous system, peripheral neurons and gastrointestinal microbiota. Stress-induced alterations in neuro-endocrine-immune pathways acts on the gut-brain axis and microbiota-gut-brain axis, and cause symptom flare-ups or exaggeration in IBS. IBS is a stresssensitive disorder, therefore, the treatment of IBS should focus on managing stress and stress-induced responses. Now, non-pharmacological approaches and pharmacological strategies that target on stress-related alterations, such as antidepressants, antipsychotics, miscellaneous agents, 5-HT synthesis inhibitors, selective 5-HT reuptake inhibitors, and specific 5-HT receptor antagonists or agonists have shown a critical role in IBS management. A integrative approach for IBS management is a necessary.

Systematic review: The placebo effect of psychological interventions in the treatment of irritable bowel syndrome

AIM To determine the placebo response rate associated with different types of placebo interventions used in psychological intervention studies for irritable bowel syndrome. METHODS Randomized controlled trials comparing psychological interventions(stress management/relaxation therapy(cognitive) behavioral therapy, short-term psychodynamic therapy, and hypnotherapy) for the treatment of adult patients with irritable bowel syndrome(IBS) diagnosed with the Manning or Rome criteria with an adequate placebo control treatment and reporting data on IBS symptom severity were identified by searching Pub Med, Embase, the Cochrane Library, CINAHL and Psyc INFO databases. Full-text articles that were written in English and published between 1966 and February 2016 in peer-reviewed journals were selected for the present review. Placebo interventions were considered to be adequate if the number of sessions and the amount of time spent with the therapist were the same as in the active treatment. The placebo response rate(PRR) was computed for IBS symptom severity(primary outcome measure) as well as for anxiety, depression and quality of life(secondary outcome measures). RESULTS Six studies, with a total of 555 patients met the inclusion criteria. Four studies used an educational intervention, whereas two studies used a form of supportive therapy as the placebo intervention. The PRR for IBS symptom severity ranged from 25% to 59%, with a pooled mean of 41.4%. The relative PRR for the secondary outcome measures ranged from 0% to 267% for anxiety, 6% to 52% for depression 20% to 125% for quality of life. The PRR associated with pharmacological treatments, treatment with dietary bran and complementary medicine ranged from 37.5% to 47%. Contrary to our expectations, the PRR in studies on psychological interventions was comparable to that in studies on pharmacological, dietary and alternative medical interventions.CONCLUSION The PRR is probably determined to a larger extent by patient-related factors, such as expectations and desire for the treatment to be effective, than the content of the placebo intervention.

Serotonin transporter and cholecystokinin in diarrhea-predominant irritable bowel syndrome: Associations with abdominal pain, visceral hypersensitivity and psychological performance

BACKGROUND Visceral hypersensitivity and psychological performance are the main pathophysiological mechanisms of irritable bowel syndrome(IBS).Previous studies have found that cholecystokinin(CCK)can enhance colon movement and that serotonin transporter(SERT)is a transmembrane transport protein with high affinity for 5-hydroxytryptamine,which can rapidly reuptake 5-hydroxytryptamine and then regulate its action time and intensity.We speculate that SERT and CCK might play a role in the pathogenesis of diarrheapredominant IBS(IBS-D)by affecting visceral sensitivity and the brain-gut axis.AIM To determine SERT and CCK levels in IBS-D patients diagnosed using Rome IV criteria and to analyze their associations with abdominal pain,visceral hypersensitivity and psychological performance.METHODS This study collected data from 40 patients with IBS-D at the China-Japan Friendship Hospital from September 2017 to April 2018 and 18 healthy controls.The severity of abdominal pain,visceral sensitivity and psychological performance were evaluated in IBS-D patients and healthy controls,the levels of SERT and CCK in plasma and colonic mucosa were evaluated,and the correlations between them were analyzed.RESULTS There were significant differences in the initial sensation threshold(31.00±8.41 mL vs 52.22±8.09 mL,P<0.001),defecating sensation threshold(51.75±13.57 mL vs 89.44±8.73 mL,P<0.001)and maximum tolerable threshold(97.25±23.64 mL vs 171.11±20.83 mL,P<0.001)between the two groups.IBS-D patients had more severe anxiety(7.78±2.62 vs 2.89±1.02,P<0.001)and depressive(6.38±2.43 vs 2.06±0.73,P<0.001)symptoms than healthy controls.Significant differences were also found in mucosal CCK(2.29±0.30 vs 1.66±0.17,P<0.001)and SERT(1.90±0.51 vs 3.03±0.23,P<0.001)between the two groups.There was a significant positive correlation between pain scores and mucosal CCK(r=0.96,0.93,0.94,P<0.001).Significant negative correlations between anxiety(r=-0.98;P<0.001),depression(r=-0.99;P<0.001),pain evaluation(r=-0.96,-0.93,-0.95,P<0.001)and mucosal SERT were observed.CONCLUSION IBS-D patients had psychosomatic disorders and visceral hypersensitivity.SERT and CCK might be involved in the pathogenesis of IBS-D by regulating the braingut axis and affecting visceral sensitivity.This provides a new potential method for identifying a more specific and effective therapeutic target.

Effect of CICARE communication nursing model combined with motivational psychological intervention in patients with postintensive care unit syndrome

BACKGROUND Post-intensive care syndrome(PICS)is a term used to describe a constellation of new or worsened dysfunctions in the physical,cognitive,or mental health status of critically ill patients after their discharge from the intensive care unit(ICU).These dysfunctions persist beyond the acute phase of illness and have a significant impact on both the patient and their family.Connect,Introduce,Communicate,Ask,Respond,Exit(CICARE)communication advocates that patients should be respected and accepted when receiving medical services.Clinicians should attach importance to the communication mode of feelings,including connection,introduction,communication,ask,response,and exit 6 steps.AIM To assess the impact of CICARE communication on the reduction of anxiety,depression,and post-traumatic stress disorder(PTSD)symptoms in patients transitioning from the ICU to other care settings.METHODS This prospective,randomized,controlled study was performed between October 2021 and March 2023.Intensive Care Unit Memory Tool was used to evaluate patients’ICU memory.The Hospital Anxiety and Depression Scale was employed to determine the presence of anxiety or depression symptoms.Impact of Event Scale-Revised was utilized to assess the presence of PTSD.All data were processed and analyzed using R language software version 4.1.0.The measurement data were expressed as mean±SD,and the t test was used.The count data were analyzed by theχ2 test and expressed as[n(%)].RESULTS In total,248 subjects were included in this study.Among them,206 were successfully followed up for three months after transfer from the ICU,and 42 cases were lost to follow-up.There was no significant difference in the composition of ICU memory between the two groups.The application of the CICARE communication nursing model combined with the motivational psychological intervention nursing model,as well as the adoption of only the motivational psychological intervention nursing model,demonstrated favorable effects on PICS.Both groups of patients showed a reduction in anxiety scores,depression scores,and PTSD scores following the implementation of these two nursing models.However,it is noteworthy that the experimental group exhibited greater improvements compared to the control group.CONCLUSION Our findings suggest that CICARE communication nursing mode may have good influence on relieving PICS.

Research on the Interventional Effects of Stress Psychological Nursing Method on Patients with Acute Coronary Syndrome

Objective: To investigate the interventional effects of stress psychological nursing method on patients with acute coronary syndrome (ACS). Methods: 100 patients with ACS who were rescued in the emergency department and department of cardiology of our hospital between January 2017 and December 2017 were enrolled. According to the random number method, the patients were divided into control group and observation group. There were 50 patients in each group. The interventions were given as routine nursing and stress psychological nursing, and the results of the two interventions were compared. Results: Before the intervention, there was no difference in the general clinical data between the control group and the observation group, which was not statistically significant;after the intervention for anxiety and depression, average hospitalization time, and off-bed time, the difference in data between the control group and the observation group on anxiety and depression was statistically significant. Moreover, the values of all the observation groups were lower than those of the control group. Conclusion: Applying stress psychological nursing method to the nursing of the patients with ACS can significantly improve their anxiety and depression, which significantly improves their quality of life, and enables the patients to better grasp the relevant health knowledge, at the same time, it obtains good intervention effects, which is worth promoting in a wider clinical scope.

This pain drives me crazy:Psychiatric symptoms in women with interstitial cystitis/bladder pain syndrome

BACKGROUND Interstitial cystitis/bladder pain syndrome(IC/BPS)is an at least 6-mo noninfectious bladder inflammation of unknown origin characterized by chronic suprapubic,abdominal,and/or pelvic pain.Although the term cystitis suggests an inflammatory or infectious origin,no definite cause has been identified.It occurs in both sexes,but women are twice as much affected.AIM To systematically review evidence of psychiatric/psychological changes in persons with IC/BPS.METHODS Hypothesizing that particular psychological characteristics could underpin IC/BPS,we investigated in three databases the presence of psychiatric symptoms and/or disorders and/or psychological characteristics in patients with IC/BPS using the following strategy:("interstitial cystitis"OR"bladder pain syndrome")AND("mood disorder"OR depressive OR antidepressant OR depression OR depressed OR hyperthymic OR mania OR manic OR rapid cyclasterisk OR dysthymiasterisk OR dysphoriasterisk).RESULTS On September 27,2023,the PubMed search produced 223 articles,CINAHL 62,and the combined PsycLIT/PsycARTICLES/PsycINFO/Psychology and Behavioral Sciences Collection search 36.Search on ClinicalTrials.gov produced 14 studies,of which none had available data.Eligible were peer-reviewed articles reporting psychiatric/psychological symptoms in patients with IC/BPS,i.e.63 articles spanning from 2000 to October 2023.These studies identified depression and anxiety problems in the IC/BPS population,along with sleep problems and the tendency to catastrophizing.CONCLUSION Psychotherapies targeting catastrophizing and life stress emotional awareness and expression reduced perceived pain in women with IC/BPS.Such concepts should be considered when implementing treatments aimed at reducing IC/BPS-related pain.

Effect of psychological nursing interventions on effectiveness and quality of life in schizophrenia patients receiving modified electroconvulsive therapy

BACKGROUND Schizophrenia is a common and severe mental disorder characterized by severe thought disturbances,hallucinations,delusions,and emotional instability.For some patients,conventional treatment methods may not effectively alleviate symptoms,necessitating the use of alternative therapeutic approaches.Modified electroconvulsive therapy(MECT)is an effective treatment modality for schizophrenia,inducing anti-depressive and antipsychotic effects through the stimulation of brain electrical activity.AIM To explore the impact of psychological nursing intervention(PNI)before and after MECT on the efficacy and quality of life of patients with schizophrenia.METHODS Eighty patients with schizophrenia who received MECT treatment from 2021 to 2023 were randomly divided into two groups:The intervention group(n=40)and the control group(n=40).The intervention group received PNI before and after MECT,while the control group received routine nursing care.The efficacy of MECT was evaluated by the Positive and Negative Syndrome Scale(PANSS)and the Clinical Global Impression Scale(CGI)before and after the treatment.The quality of life was assessed by the Short Form 36 Health Survey(SF-36)after the treatment.RESUITS The intervention group had significantly lower scores of PANSS and CGI than the control group after the treatment(P<0.05).The intervention group also had significantly higher scores of SF-36 than the control group in all domains except physical functioning(P<0.05).CONCLUSION PNI before and after MECT can improve the efficacy and quality of life of patients with schizophrenia.It is suggested that nurses should provide individualized and comprehensive psychological care for patients undergoing MECT to enhance their recovery and well-being.

Cognitive-behavioral therapy for the management of irritable bowel syndrome

Irritable bowel syndrome(IBS)is a common disorder,reported to be found in 5%-20%of the general population.Its management accounts for up to 25%of a gastroenterologist’s workload in the outpatient department,and the main symptoms are abdominal pain,bloating,and altered bowel habits.Despite a great amount of available pharmacological treatments aimed at a wide variety of gastrointestinal and brain targets,many patients have not shown adequate symptom relief.In recent years,there has been increasing evidence to suggest that psychological treatments,in particular cognitive-behavioral therapy(CBT),are effective for the management of IBS.This review discusses CBT for the management of IBS.CBT has proved to be effective in alleviating the physical and psychological symptoms of IBS and has thus been recommended as a treatment option for the syndrome.

Treatment of psychological co-morbidities in common gastrointestinal and hepatologic disorders

Anxiety and depressive disorders frequently coexist with gastrointestinal and hepatologic conditions.Despite their high prevalence,approach to treating these co-morbidities is not always straightforward.This paper aims to review the current literature into etiology of psychological comorbidities and their treatment in three conditions commonly encountered at gastroenterology outpatient clinics,namely inflammatory bowel disease(IBD),irritable bowel syndrome(IBS) and chronic hepatitis C(HepC).The paper demonstrates that although psychotherapy(and cognitive-behavioural therapy in particular) has been established as an effective treatment in IBS,more studies are needed in HepC and IBD.Antidepressants have been recognized as an effective treatment for psychological and somatic symptoms in IBS and for depression in HepC,but good quality studies in IBD are lacking despite the promising preliminary findings from animal models and case studies.Further studies in this area are needed.

Review of possible psychological impacts of COVID-19 on frontline medical staff and reduction strategies

Like soldiers,frontline medical staff provide a first line of defense and have played a critical role in responses to the outbreak of coronavirus disease-2019 in December 2019.It is important to acknowledge the considerable pressure placed on frontline medical staff in the face of a new type of coronavirus that is highly infectious and for which no specific treatment is available.Here,we review the various kinds of psychological problems afflicting frontline medical staff who are combatting the severe acute respiratory syndrome epidemic.These include anxiety,insomnia,depression,interpersonal difficulties,and post-traumatic stress disorder syndrome.We further present a summary of countermeasures for alleviating these problems based on our findings.These countermeasures include ensuring the provision of adequate protective gear for frontline medical staff,developing timely and clear guidelines,strengthening social support,and providing clear criteria and additional training,focusing on the choice of frontline medical staff.An understanding of the psychological impacts of an epidemic situation and of relevant countermeasures will contribute to reducing the psychological pressures on frontline medical staff.Consequently,they will be able to cope better with outbreaks of infectious diseases in the future,to reduce the psychological pressure of the front-line medical staff,and to improve the treatment level.

Summary of Home Nursing for Lens Dislocation Among Patients with Marfan Syndrome

Marfan syndrome is a rare genetic disease,and the condition of most patients deteriorates with age.The lesions are mainly cardiovascular,skeletal,and ocular lesions.Its clinical manifestations are characterized by congenital heart disease,ectopic lens,slender body,slender limbs,spider fingers(toes),and general muscle dysplasia.In the early stage of this disease,when the symptoms are not yet clearly manifested,some patients came to the hospital for treatment due to decreased vision.According to the particularity of crystal dislocation patients with Marfan syndrome,this article provides home nursing education in terms of physiological and psychological aspects,and builds an effective home nursing model to promote the physical and mental recovery of patients.

Analysis of the Effect of Mindfulness Meditation on Patients with Burning Mouth Syndrome

Objective:To explore the effect of mindfulness meditation on patients with burning mouth syndrome.Methods:60 patients with burning mouth syndrome in our hospital who were treated from January 2021 to December 2022 were selected for this study.The patients were divided into two groups of thirty cases each using the randomized numerical table method.The observation underwent psychological intervention and mindfulness meditation training,while the control group only received symptomatic care.The condition of the patients of both groups was observed and compared.Results:Upon receiving treatment,the patients in the observation group had lower Hamilton Anxiety(HAM-A)scores,and Hamilton Depression(HAMD)scores compared to the control group(P<0.05).The visual analog scale(VAS)scores of the observation group were also lower than those of the control group(P<0.05).Moreover,the efficacy of the nursing intervention in the observation group was higher than that of the control group(P<0.05).Conclusion:Psychological intervention and mindfulness meditation training can effectively improve the clinical symptoms of patients with burning mouth syndrome.Therefore,this treatment method should be popularized.

Assessment of the Clinical Effect of Chinese Medicine Therapy Combined with Psychological Intervention for Treatment of Patients of Peri-menopausal Syndrome Complicated with Hyperlipidemia

Objective：To observe the effect of Chinese medicine therapy combined with psychological intervention（combined therapy） on the clinical symptoms and levels of blood lipids and sex hormones of patients of peri-menopausal syndrome complicated with hyperlipidemia.Methods：With the use of a randomizing digital table method,185 patients that fit the registration standard were randomly assigned to three groups.The 59 cases in Group A were treated with two Chinese patents,Kunbao Pill（坤宝丸） and Modified Xiaoyao Pill（加味逍遥丸）;the 63 in Group B received psychological intervention alone;and the 63 in Group C were treated with both（the combined therapy）,with the treatment course for all six months.The items of observation included： （1） scoring by SCL-90 on eight factors and seven symptoms;（2） scoring on Chinese medicine symptoms by Kupermann scale,including anxiety and bad temper,scorching sense ation with sweating,dizziness,tinnitus, soreness and weakness of the loin and knees,palpitation,insomnia,lassitude,weakness,and hyposexuality; （3） blood contents of total cholesterol（TC）,triglyceride（TG）,high-density lipoprotein cholesterol（HDL-C）, low-density lipoprotein cholesterol（LDL-C）,apoprotein Al（ApoAl） and B（ApoB）;（4） levels of sex hormones, including estradiol（E_2）,progesterone（P）,pituitary prolactin（PRL）,follicular stimulating hormone（FSH）,and luteinzing hormone（LH） in some randomly selected patients;（5） adverse reaction;and（6） one-year follow-up study on long-term effect.Results：A total of 21 patients（6,8,and 7 cases in Groups A,B,and C,respectively） dropped out;the drop-out rate was insignificant among groups.（1） The markedly effective rates in Group A, B,and C were 26.42%（14/53）,18.18%（10/55）,and 53.57%（30/56）,respectively,and the total effective rates in them were 64.15%（34/53）,50.91%（28/55）,and 87.50%（49/56）,respectively,suggesting the therapeutic efficacy in Group C was significantly better than that in Groups A and B（P〈0.01）.（2） SCL-90 scoring showed that the total scores decreased significantly after treatment in Group C（P〈0.01）,but remained unchanged in Groups A and B（P〉0.05）.（3） Scoring on Chinese medicine symptoms showed the same results as shown by SCL-90 scoring in terms of total scores and individual symptoms,except that menstrual disorder and amenorrhea were unchanged in all three groups（P〉0.05）.（4） Levels of HDL-C,ApoAl,and E_2 increased and those of TG,TC,LDL-C,ApoB,FSH,and LH decreased after treatment in Group C,reaching near normal levels;similar trends of blood lipids were shown in Group A,but the level of sex hormones was unchanged.In Group B all the above-mentioned indices were unchanged（P〉0.05）.（5） A one-year follow-up study showed the markedly effective rate and the total effective rate in Group C were higher than those in the other two groups respectively（P〈0.01）.（6） No adverse reaction was found.Conclusion：Chinese medicine therapy combined with psychological intervention could not only improve the nervous symptoms,but also regulate the blood levels of lipids and sex hormones in patients of peri-menopausal syndrome complicated with hyperlipidemia.

1例抑郁症合并急性视网膜坏死综合征患者的护理

总结1例抑郁症合并急性视网膜坏死综合征(acute retinal necrosis syndrome,ARNS)患者的护理经验。护理要点为迅速评估;围绕“患者-家庭-护士”实行个性化心理护理;多种方式用药护理;个性化的镇痛与睡眠管理;安全护理;出院指导。经过积极治疗后,患者左眼视力有所提高,出院最佳矫正视力为手动/50 cm,情绪稳定,继续遵医嘱用药。重视抑郁症合并ARNS患者的护理,针对用药、心理、安全等方面制定个性化的治疗与护理方案,可有效控制抑郁症患者病情复发,改善患者视力预后,降低致盲率,提高患者生活质量。

肾病综合征患儿母亲亲职压力现状及相关研究

目的 了解肾病综合征患儿母亲亲职压力现状,探讨心理资本、家庭功能、家庭复原力与其亲职压力的相关性,并分析心理资本在家庭功能、家庭复原力和亲职压力间的中介效应。方法 采用便利抽样法,于2021年2月-2022年12月抽取新疆维吾尔自治区人民医院246名肾病综合征患儿母亲作为研究对象,采用一般情况量表、心理资本量表、家庭功能量表、家庭复原力量表和亲职压力量表对其进行调查。结果 (1)246名肾病综合征患儿母亲心理资本得分为(64.27±11.64)分,家庭功能得分为(126.82±27.46)分,家庭复原力得分为(122.92±21.81)分,亲职压力得分为(95.38±12.27)分。(2)不同文化程度、子女数、婚姻状况、医疗费支付方式、家庭结构、家庭人均月收入及患儿年龄的肾病综合征患儿母亲亲职压力得分差异有统计学意义(P<0.05)。(3)肾病综合征患儿母亲心理资本、家庭功能、家庭复原力与亲职压力分别呈负相关(r=-0.649、-0.588、-0.614,P<0.01),心理资本与家庭功能、家庭复原力分别呈正相关(r=0.618、0.744,P<0.01),家庭功能与家庭复原力呈正相关(r=0.548,P<0.01)。(4)心理资本在肾病综合征患儿母亲家庭功能、家庭复原力和亲职压力间起部分中介作用,中介效应分别占总效应的24.33%和26.97%。结论 肾病综合征患儿母亲亲职压力较高,心理资本在肾病综合征患儿母亲家庭功能、家庭复原力和亲职压力间起部分中介作用,提高其心理资本水平有助于降低亲职压力,改善患儿家庭功能,提高患儿生存质量。

互动干预模式在鼾症患儿手术围术期的应用效果

目的:探究互动干预模式在鼾症患儿手术围术期的应用效果。方法:通过随机数字表法将某院于2022年4月至2023年6月收治的102例鼾症患儿分为对照组(采用常规干预模式,50例)、观察组(采用互动干预模式,52例),比较两组患者的恢复效果、心理状态、适应行为和并发症发生率。结果:观察组总恢复效果(98.08%)显著高于对照组(80.00%)(χ^(2)=8.657,P<0.05);观察组随访半年后患儿心理状态显著高于对照组(t=6.282,P<0.05);观察组随访半年后适应行为得分显著高于对照组(t=5.159,P<0.05);观察组并发症发生情况(3.85%,2/52)显著少于对照组(18.00%,8/50)(χ^(2)=5.307,P=0.021)。结论:互动干预模式能够有效改善鼾症手术患儿围术期心理状态,促进术后症状恢复,提高其适应行为能力,降低术后并发症发生率。

综合护理在妊娠高血压综合征患者护理中的应用效果

目的探讨综合护理在妊娠高血压综合征(PIH)患者护理中的应用效果。方法选取2022年5月至2023年5月南京医科大学附属南京医院收治的80例PIH患者,依照随机数字表法分为观察组和对照组,各40例。对照组给予常规产科护理,观察组给予综合护理,比较两组血压、不良妊娠结局发生率、剖宫产率及心理状态评分。结果干预后观察组焦虑、抑郁评分低于对照组(P<0.05);干预后观察组收缩压、舒张压低于对照组(P<0.05);观察组不良妊娠结局总发生率及剖宫产率低于对照组(P<0.05)。结论综合护理干预在PIH患者护理中的应用效果较好,能够降低血压、不良妊娠结局发生率、剖宫产率,改善心理状态。

闭环式护理配合延续护理对肾病综合征患儿依从性及心理异常行为的影响

目的:探究闭环式护理配合延续护理对肾病综合征患儿依从性、心理异常行为的影响。方法:收集2019年2月—2023年2月在医院首次住院诊疗的102例肾病综合征患儿为研究对象,据抛币法分为观察组(n=51)与对照组(n=51)。对照组施行常规护理及出院前指导等方案,观察组实施闭环式护理配合延续护理方案。比较两组患儿依从性、干预前后心理异常行为评分及自我效能评分、家属满意度。结果:观察组患儿依从性为96.08%,对照组患儿依从性为80.39%,观察组高于对照组(P<0.05)。干预后两组心理异常行为评分均较干预前下降,自我效能评分均较干预前升高,且观察组改善幅度优于对照组(P<0.05)。观察组家属满意度为98.04%,对照组家属满意度为84.31%,观察组高于对照组(P<0.05)。结论:对肾病综合征患儿施行住院期间闭环式护理配合出院后延续护理,可显著提升患儿的依从性,改善患儿心理异常行为,调节其情绪状态,提升了家属对整体护理方案的满意度。

基于“思伤脾”理论探讨心理应激在干燥综合征发生发展中的作用

干燥综合征是一种慢性自身免疫性疾病,可累及多系统造成全身损害,目前发病机制尚不完全明确。近年研究发现,心理应激作为一种刺激因素,在干燥综合征的发病中起着重要作用,但尚不能完全明确心理应激所致干燥综合征的发病机制和干预靶点。而在中医理论中,同样认为情志因素作为影响干燥综合征的重要因素,其与心理应激有着本然的一致性。“思伤脾”是中医情志致病的重要内容之一,文章结合现代医学研究成果,从中医“思伤脾”理论对干燥综合征的病理机制作中西医比对,试图发掘内在联系,探索协同诊治体系,融通中西疗法互参,以期为干燥综合征的诊治提供更多的理论依据与支持。

经皮穴位电刺激在酒精依赖患者中的应用效果

目的观察经皮穴位电刺激在酒精依赖患者心理渴求和稽延性戒断症状中的应用效果。方法选取在湖南省脑科医院酒瘾科住院的120例酒精依赖完成急性脱瘾期的男性患者为研究对象,根据患者治疗方式的不同分为常规药物组、经皮穴位电刺激组及假刺激组,每组40例。常规药物组采用苯二氮[艹卓]类药物替代递减以及支持性对症治疗,经皮穴位电刺激组采用常规治疗联合经皮穴位电刺激,假刺激组采用常规治疗联合模拟经皮穴位电刺激。比较3组患者治疗前后焦虑自评量表(SAS)评分及抑郁自评量表(SDS)评分、饮酒迫切性量表(AUQ)评分、视觉模拟评分法(VAS)评分、匹兹堡睡眠质量指数(PSQI)评分及复发情况。结果治疗后,3组患者SAS、SDS、AUQ及VAS评分均较治疗前降低,且经皮穴位电刺激组以上评分均低于常规药物组及假刺激组,差异有统计学意义(P<0.05)。治疗后,3组患者睡眠质量、入睡时间、睡眠时间、睡眠效率、睡眠障碍、催眠药物、日间功能障碍评分及PSQI总分均低于治疗前,且经皮穴位电刺激组以上评分均低于常规药物组及假刺激组,差异有统计学意义(P<0.05)。经皮穴位电刺激组复发率低于常规药物组及假刺激组,差异有统计学意义(P<0.05)。结论相较于常规治疗及模拟经皮电刺激,经皮穴位电刺激治疗更有利于减轻患者焦虑、抑郁及失眠等稽延性戒断症状严重程度,并利于降低患者心理渴求程度,从而降低复发率。